﻿<!DOCTYPE html PUBLIC "-//W3C//DTD XHTML 1.0 Transitional//EN" "http://www.w3.org/TR/xhtml1/DTD/xhtml1-transitional.dtd">
<html xmlns="http://www.w3.org/1999/xhtml">
<head>
    <title></title>
    <script src="Templates/JS/ajax-submit-form.js" type="text/javascript"></script>
</head>
<body style="width:250px; height:140px;">
<!--
Do not modify the NAME value of any of the INPUT fields
the FORM action, or any of the hidden fields (eg. input type=hidden).
These are all required for this form to function correctly.
-->
<style type="text/css">

	

	.required {
		color: red;
	}

    .style1
    {
        width: 220px;
        text-align: right;
    }

    .style2
    {
        width: 130px;
        text-align: left;
        color: White;
        font-weight: bold;
    }

    .csssubmit
    {
        width: 111px;
        height: 35px;
    }

    .style3
    {
        width: 220px;
        text-align: center;
    }
    #signin_submit {
         background: url("Templates/Images/submit.png") no-repeat scroll 0 0 transparent;
        border: medium none;
        display: block;
        height: 34px;
        margin: 5px auto 0;
        text-decoration: none;
        text-indent: -99999px;
        width: 91px;
    
    }
    #signin_submit:hover, #signin_submit:focus
    {
        cursor:pointer;
        }
        
        input[type="text"]{
            border: 1px solid #AACCEE;
            border-radius: 4px 4px 4px 4px;
            display: block;
            font-size: 13px;
            margin: 0 0 5px;
            padding: 5px;
            width: 160px;
        }

</style>
<div id="MyResult">
<form method="post" action="" id="frmSS1" name="frmSS1" onsubmit="return CheckForm1(this);">
	<table border="0" cellpadding="2" class="myForm">
		<tr>
	<td class="style2">Tên bạn</td>
	<td style="text-align: right" ><input type="text" name="CustomFields[3]" id="CustomFields_3_1" value="" size='25'></td>
</tr><tr>
	<td class="style2">Email<span class="required">&nbsp;*</span></td>
	<td class="style1"><input type="text" name="email" value="" size='25'/></td>
</tr><input type="hidden" name="format" value="h" />
		<tr>
			<td class="style2"></td>
			<td class="style3">
				<input class="csssubmit" id="signin_submit" type="submit" value="Đăng ký" />
				<br/>
			</td>
		</tr>
	</table>
</form>

<script type="text/javascript">
// <![CDATA[

    function CheckMultiple1(frm, name) {
        for (var i = 0; i < frm.length; i++) {
            fldObj = frm.elements[i];
            fldId = fldObj.id;
            if (fldId) {
                var fieldnamecheck = fldObj.id.indexOf(name);
                if (fieldnamecheck != -1) {
                    if (fldObj.checked) {
                        return true;
                    }
                }
            }
        }
        return false;
    }
    function CheckForm1(f) {
        var email_re = /[a-z0-9!#$%&'*+\/=?^_`{|}~-]+(?:\.[a-z0-9!#$%&'*+\/=?^_`{|}~-]+)*@(?:[a-z0-9](?:[a-z0-9-]*[a-z0-9])?\.)+[a-z0-9](?:[a-z0-9-]*[a-z0-9])?/i;
        if (!email_re.test(f.email.value)) {
            alert("Địa chỉ Email chưa hợp lệ.");
            f.email.focus();
            return false;
        }
        
        xmlhttpPost('http://app.nllsender.com/form.php?form=1', 'frmSS1', 'MyResult', '<img src=\'Templates/Images/loading_icon.gif\'>'); return false;
        //return true;
    }
		
// ]]>
</script>
    </div>
</body>
</html>
